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Query: UMLS:C0000729 (abdominal cramps)
 531 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Surveys of athletes, primarily runners, have shown that digestive disorders are common, associated both with training and racing. Women, in particular, seem to suffer most commonly. Nearly half have loose stools and nausea and vomiting occur frequently after hard runs. Diarrhoea, incontinence and rectal bleeding occur with surprising frequency. Runners may use medications prophylactically to minimise some of these symptoms. Upper digestive symptoms seem to occur more commonly in multisport events such as triathlons or enduro. The published literature is difficult to analyse and the basic intestinal physiology not well studied. Most gastroenterologists are accustomed to evaluating the fasting patient at rest and exercise physiologists are seldom experienced with digestive techniques. Digestive symptoms occurring with exercise referable to the oesophagus include chest pain, gastro-oesophageal reflux symptoms, or symptoms related to alterations in motility. While little is known of the oesophageal physiology during exercise, it is believed that only minimal changes occur in most subjects. Gastro-oesophageal reflux occurs more frequently with exercise than at rest and may produce symptoms of chest pain suggestive of ischaemic disease. Acid exposure may be reduced by pretreatment with histamine H2-receptor antagonists. Oesophageal symptoms, though common, are rarely disabling to the athlete, and the clinical importance lies in confusion with ischaemic disease. Cases of acute gastric stasis following running have been reported and gastric physiology during exercise, particularly bicycling, has been more actively investigated. Gastric emptying during exercise is subject to a number of factors including calorie count, meal osmolality, meal temperature and exercise conditions. However, it is generally accepted that light exercise accelerates liquid emptying, vigorous exercise delays solid emptying and has little effect upon liquid emptying until near exhaustion. Gastric acid secretion probably changes little with exercise although some have postulated that ulcer patients may increase secretion with exercise. Some exercise-associated digestive symptoms, such as diarrhoea and abdominal pain, have been attributed to changes in intestine function. Small bowel transit is delayed by exercise when measured by breath hydrogen oral caecal transit times and motility may be reduced as well. Intestinal absorption during exercise has not been well evaluated but probably changes little in ordinary circumstances. Passive absorption of water, electrolytes and xylose are not affected by submaximal effort. Colonic transit and function is even more difficult to evaluate and published results have been conflicting. However, it is likely that many of the lower digestive complaints of runners such as diarrhoea and lower abdominal cramps are due to direct effects of exercise upon the colon.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The effect of exercise on the gastrointestinal tract. 218 30

Patient-controlled analgesia (PCA) is designed to avoid both excessive and inadequate analgesia in postoperative pain by allowing the patient self-administration of intravenous narcotics within a range of parameters established by the physician. Of 24 patients undergoing elective cholecystectomy referred to our study over a 12-month period, 11 were assigned to PCA and eight successfully completed the study. Most of them had good analgesia, were satisfied with PCA, and had no evidence of confusion, psychic distress, or visual-motor impairment. Serum morphine concentrations of 10-30 ng/mL were sufficient to obtain good analgesia in six of eight patients. Complications included severe respiratory depression and abdominal cramps.
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PMID:Patient-controlled analgesia for postcholecystectomy pain: a pilot study. 230 69

A 61-year-old woman presented with an acute condition involving confusion, abdominal cramps and bloody diarrhea six hours after accidental ingestion of colocynth mistaken for zucchini. Colonoscopic examination revealed pseudomembranous colitis though the patient had no condition known to be associated with pseudomembranous colitis. Within ten days the mental state returned to normal and the colitis resolved completely. It is suggested that the colitis was caused by the ingestion of colocynth.
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PMID:[Pseudomembranous colitis caused by the ingestion of colocynth]. 382 25

With the current increase of international travel to tropical endemic areas, the incidence of malaria being imported into nonendemic countries has increased significantly. Disagreement concerning malaria chemoprophylaxis and inadequate knowledge of malarious areas, morbidity, and pretravel advise has led to confusion among both health professionals as well as travelers. Therefore, this study was conducted to investigate malaria imported into Germany by identifying the high-risk endemic areas, clinical presentations, and chemoprophylactic and therapeutic regimens related to reported cases. Between 1990 and 1993, the 160 nonimmune travelers, all German nationals or residents for more than 10 years, presenting to our travel clinic with microscopically confirmed malaria were investigated. For each, the travel history, chemoprophylaxis used during travel, symptoms, pathological diagnosis, and treatment efficacy were analyzed. Africa (73%), Asia (21%), and Central South America (6%) were the endemic countries visited by our patients, of whom only 3% used the chemoprophylaxis recommended for their destination. Plasmodium falciparum was the most common pathogen, found in more than half of our patients, and P. vivax (29%), P. ovale (6%), P. malariae (6%), a mixed infection with P. falciparum and P. vivax (3%) were also detected. All patients presented with fever and headaches, a majority with profuse night sweats, insomnia, arthralgias, and myalgias, and diarrhea and abdominal cramps were experienced in 13% and 8%, respectively. In falciparum malaria, a recrudescence was observed in all patients who received chloroquine only, whereas quinine, halofantrine, and mefloquine were highly effective. In vivax malaria, a relapse rate of 14% was noted in patients treated with the currently recommended regimen of chloroquine and primaquine. Visitors to endemic countries, especially Africa, are of significant risk. Given the low compliance rate of chemoprophylaxis, a high precentage of malaria in our patients could have been avoided by an appropriate prophylaxis regimen and optimal pretravel counseling.
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PMID:Malaria in Nonimmune Travelers: A Synopsis of History, Symptoms, and Treatment in 160 Patients. 981 39

Guam school children and faculty members experienced symptoms of vomiting, nausea, abdominal cramps, and diarrhea shortly after eating breakfast prepared by contracted caterers. The first illness was reported within an hour after breakfast, affecting 295 students and two faculty members. Local hospitals treated 130 people, and 61 were admitted for further treatment. Reported symptoms were consistent with staphylococcal food poisoning. Initial food testing using a lateral flow device and electrochemiluminescence method incorrectly implicated staphylococcal enterotoxin B as the causative agent, prompting partial activation of Guam's Emergency Response Center. Traditional ELISAs proved that the food poisoning agent was staphylococcal enterotoxin D. More specific and sensitive assays would have alleviated the issues and confusion that surrounded the reporting and investigation of this outbreak.
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PMID:Staphylococcal enterotoxin B-specific electrochemiluminescence and lateral flow device assays cross-react with staphylococcal enterotoxin D. 2505 35

BACKGROUND Systemic lupus erythematosus (SLE) has myriad manifestations that can affect any organ system in the body. Macrophage activation syndrome (MAS) is a disease of uncontrolled lymphocyte and macrophage proliferation and activation, which has various triggers, including autoimmune disorder, viral infection, and malignancy. We report here on MAS as a complication of adult SLE, a rare association in the literature, in a patient with an unknown past medical history. CASE REPORT A 38-year-old male patient presented with severe muscle weakness, diffuse abdominal cramps with vomiting and incontinence of stool, confusion, cough, and sweating increasing in severity for about 1 week. He was unable to give a coherent history and according to his family had been released from prison 3 weeks prior, having been in the corrections system for much of his adult life. The diagnosis of new-onset fulminant SLE complicated by MAS was made, noting the profound degree of bone marrow involvement, neuropsychiatric changes, and hyperferritinemia. CONCLUSIONS Many of the symptoms, signs, and laboratory findings of SLE overlap with those of MAS, and concomitant presence of both of these disease poses unique diagnostic challenges as well as extreme risk to the patient. A robust set of criteria for identifying MAS in the setting of a confounding underlying rheumatological illness does not exist in the adult population; this case illustrates the approach taken by our team to come to this diagnosis.
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PMID:Macrophage Activation Syndrome (MAS) in a Recently Released Prisoner with Systemic Lupus Erythematosus (SLE). 2993 Feb 39